Global Lab for Innovation

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Global Lab for Innovation"

Transcription

1 Global Lab for Innovation Innovation Profile Tele-Primary Care Visits Audiovisual consultations with primary care physicians (also known as Virtual Primary Care or Tele-Outpatient Visits) decrease total cost of care and help patients avoid more complex interventions. Studies comparing e-visits with face-to-face care demonstrated an average or net savings of $19 to $92 per case. Application Profiled Here: TelaDoc and Health Partners Virtuwell What it is These services offer patients primary care consultations with physicians or nurse practicioners (NPs) through audio-visual tele-communications. Tele-primary care visits are available 24/7 and without appointments to patients who need non-acute care. Consultations are conducted through secure audiovisual connections over computers and smart phones, allowing patients to access care from home, work or other locations. Summary Application Profiled: TelaDoc and Health Partners Virtuwell Category Savings Level 2 Access Experience Engagement Outcomes Barriers Regulatory Investment $ Training EMR Integration Potential for Spread Documented, Focused NR User Sites <30 Moderate Favorable Problems addressed Patients use Emergency Departments (ED) and urgent care clinics which are much more costly than primary care visits for convenience, drop-in care, to avoid commuting to see their doctor, or while they are traveling. A shortage of primary care physicians limits the availability of appointments. Patients with communicable diseases may infect others while visiting the clinic. Patients who are ill may not feel well enough to travel to a clinic and instead go untreated.

2 How it works Patients visit a website or call an 800 number to describe their problem and request an appointment. Only relatively simple conditions such as respiratory, urinary tract infections, or conjunctivitis are scheduled for virtual consultation. Potentially serious or complex conditions are referred for face to face care. 1 Appointments for a consultation with a physician or nurse practitioner are usually made for a time within 30 minutes to several hours of the request. The clinician and patients can communicate through a variety of methods: phone, structured asynchronous online communication, videoconferencing, or a combination. The tele-primary care clinician may give a diagnosis, prescribe antibiotics and other non-controlled scripts, recommend self-management or follow-up care, or refer for a face-to-face appointment. Protocols direct the care given. Records and payment arrangement vary with the service and are dependent on how integrated the service is in the delivery system. Where the tele-primary care service is offered by a delivery system or by a contractor to the delivery system, a record of the encounter is entered into the patient s electronic medical record (EMR.) The service is a covered service and patients pay similar co-pay portions as for a face-to-face visit. When the tele-primary care service is offered outside of a delivery system patients typically pay in full with a credit card. Direct savings are achieved through lower charges per visit than office visits and much lower charges than ED or acute care clinics or other alternative care sites. Where tele primary care visits resolve problems at similar or higher rates than the alternative care, there is no offset from additional follow-up visits. Longer term, indirect savings may accrue where patients obtain prompter care from tele visits and thus avert need for more complex interventions. Additionally, by directing low acuity conditions to a virtual service, EDs and Urgent Care sites can be decompressed to allow patients that require those face to face visits to see providers in a timely manner. Innovators TelaDoc the first tele-primary care service in the US began in 2002 with a telephone, direct-to-consumer offering of consultations with primary care physicians. TelaDoc has since added audio-visual and internet consultations and also contracts nationally with delivery systems and health plans. In 2010, HealthPartners in Minnesota initiated an on-line clinic for their members called Virtuwell. The online clinic is available at all hours and is staffed by NPs who follow specific care protocols. Patients may interact with the NP online or either party may call the other at any point during the consultation. Other firms offering tele-primry care include: Zipnosis, founded in Minneapolis in 2010, and offering an online survey and response service monitored by primary care physicians and NPs. KP Oncall a service initiated in 2010 by Kaiser Permanente. American Well, a telehealth company founded in Boston in 2008, 2,3 partnered with WellPoint (a for-profit managed care firm) in 2013 to offer the Live HealthOnline (LHOL) service to consumers and to delivery systems. 4 LHOL has a number of academic medical system clients, including UCLA Health through the Anthem insurance plan. In addition to these providers a number of commercial insurance plans contract for tele-visit services, for example many of the state Blues plans, United, and several VA programs offer members access to LHOL. Allina Health, a provider network in Minnesota, offers a service they refer to as e-visits to their members. Carena in Seattle contracts with providers to install tele-clinic systems which Carena will staff with its own clinicians or with the clients clinicians whom they will also train. Some academic medical centers, such as the University of Pittsburgh, have also developed their own tele-primary care consultation services. Global Lab Profile 2

3 Complexity (How complex are the organizational requirements) Focused. When delivery systems contract with a vendor who provides a secure platform and physician services. If the online consultation reports are filed in patients records and reported to their primary care physician, connectivity bridges must be developed, installed and maintained. Communication programs are required to make enrollees aware of the service and encourage them to register with it. TelaDoc, Carena, and LHOL report that they work with the delivery system s IT and communications departments for implementation, which can be done in less than a year. LHOL summarizes the preparation required by a delivery system as primarily physician s time, hardware and internet connection. 5 May be complex when delivery systems build their own internal service and requires enrollees to register with that service. Kaiser reports that they invested in multi-year efforts to register patients, train MDs, and develop use of its KP Oncall service. 6 Virtuwell reports that their online care service was designed, implemented, and realized savings within two years. Savings Yes. Virtuwell reports savings of $88 per episode. Both TelaDoc and Virtuwell report fees per tele-visit as $40 or $38 respectively. 7 Average costs for primary care visit for an existing-patient physician visit is roughly $ To the extent that the telehealth visit substitutes for a physician visit, the immediate direct savings would be $110/visit. Where telehealth visits substitute for ED or urgent care clinics, the savings would be much larger. TelaDoc visits were found to have lower rates of follow-up visits than face-to-face visits in a study of California state employees in an HMO offering TelaDoc consultations. 9 Mercer did an assessment of TelaDoc patients surveyed to determine what mix of alternative care (urgent care clinic, ED, primary care, specialist care, or no care) the user would have sought if TelaDoc were not available to them. Using this weighted mix, they found a net savings of $92 per case. 10 Two other tele-primary care providers have reported estimated savings: A study of e-visits at University of Pittsburgh found that for Medicare patients with urinary tract infections (UTIs) the average savings per case was $19 (including visit, lab tests and scripts). 11 Wellpoint reported LHOL savings on average of $45 per e-visit compared to a face-toface visit. 12 In a capitated system, the delivery system may realize savings by substituting tele-visits as lower cost interventions for office or urgent care visits. Health Plans may realize savings when they pay lower levels of reimbursement for virtual than for office visits. Patients may realize savings where their out-of-pocket charges for virtual visits are less than that of face-to-face care that they would have obtained. Access Yes. Patients gain access to clinicians during non-standard practice times and have virtual access to clinicians from home, office, and other sites where they have connectivity. A study of TelaDoc services to an HMO patient population found that more than a third of tele-visits were made on weekends. The same study found that 21% of TelaDoc patients had not used health care previously during the study year. 13 Global Lab Profile 3

4 Patient experience Yes. A survey of Virtuwell patients by HealthPartners found that 98% of patients would recommend this service. 14 A Mercer study of TelaDoc patients reported patient satisfaction to be over 90%, with 85% of cases resolved through the online encounter. 15 Engagement No information was available on patient engagement. Outcomes No reports of patient clinical or functioning status outcomes were found for TelaDoc or Virtuwell patients. At the University of Pittsburgh a study comparing treatment records for e-visit and office visit patients with UTIs and sinusitis found equivalent rates of follow-up visits and calls. This finding suggest similar rates of treatment success; however, the same study found somewhat higher rates of antibiotic scripts for e-visit patients and lower rates of preventative care interventions. Spread An estimated 40 private insurance firms and delivery systems offer tele-primary care visits. Most of the commercial services, such as TelaDoc, also have a direct-to-consumer service. No Medicaid program adopters were identified. Barriers and Drivers Barriers Regulatory: Due to state licensing regulations, virtual physicians may only have encounters with patients in states of licensure. Tele consultation services report that recruiting and maintaining access for care by MDs licensed across multiple states is a key restriction on expanded geographic coverage. Regulatory: Some states have regulations requiring that prescriptions can only be given based on a face-to-face encounter or where the patient and physician have an established relationship. Regulatory: Some states also require that a prescribing physician must be located in the same state as the patient, regardless of licensure. Drivers Patient Preference: Patients strongly prefer virtual access to primary care; Cost of Care: High fees associated with ED and other urgent care motivates payers to offer virtual visit alternatives. Global Lab Profile 4

5 Similar innovations Other telehealth care services such as tele-dermatology and tele-dentistry (both of which are profiled) and telepsychology rely upon audio-visual connectivity to deliver care. In the summer of 2014 Verizon introduced a virtual visits service on its android mobile telephones. These visits can be conducted over 3G or 4G connections, and the service is provider agnostic and available for a fee to any primary care provider to use for telehealth consultations. MDLive also offers a telehealth app for MD visits. Sherpaa offers telehealth consultations to business and as a consumer product. Most recently, Pager launched an offering. Innovation contact Teladoc, Daniel Trencher, Senior Vice President, Business Development Virtuwell, Kevin Palattao, Vice President Address Website Original Date of Post 2014 Endnotes 1 Health Partners internal online clinic, virtuwell, has a list of 40 conditions that its nurse practitioners treat. Courneya, Kevin, et. al. HealthPartners Online Clinic for Simple Conditions Delivers Savings of $88 Per Episode and High Patient Approval, Health Affairs, American Well also partners with Blue Cross, Blue Shield, WellPoint, Ascension Health, Medibank (Australia/New Zealand), Rite Aid, Tufts Medical Center, U.S. Department of Veterans Affairs, and others, American Well: Our Partners. patient/aboutus.html). 3 American Well launched a three-pronged telehealth pilot program at Mass General focusing on Child and Adolescent Psychiatry, Heart Failure and Neurology [American Well Announces Telehealth Pilot for Clinical Care Programs at Massachusetts General Hospital. (April 8, 2013). 4 The software platform was developed by American Well in Boston. There are multiple other installations of the software, but they are branded otherwise. communication from Wallace Adamson, Sr VP, Strategic Partnerships, Live Health Online LiveHealth Online currently operates as a registered trademark of WellPoint, Inc. LHOL plans to launch a Practice Edition which will allow providers to use LHOL in their own practice for their own patients. LHOL also makes its systems available to delivery systems to operate with their own clinicians who may be physicians or nurse practitioners or physician assistants 5 Ibid. 6 Perle, R. Kaiser Permanents Northern California: Current Experience with Internet, Mobile, and Video Technologies, Health Affairs, Courneya, op.cit. 8 Average fee in US for a primary care physician visit is reported to be $158/visit. 9 Uscher-Pines, Lori, Analysis of Teladoc Use Seems to Indicate Expanded Access To Care For Patients Without Prior Connection to a Provider, Health Affairs, Fifer, S, Telemedicine MD Visits: Patient Satisfaction and Use Patterns Among Working Age Adults, Mercer White Paper, This estimate was based on Medicare fees in CY 2010 and Mehrota, A, A Comparison of e-visits and Office Visits for Sinusitis and Urinary Tract Infections. JAMA Internal Medicine Research Letter, January This estimate is based on assumptions that include alternative face to face care would involve a portion of ED visits. 13 Uscher-Pines, op. cit. 14 Health Affairs: HealthPartners Online Clinic For Simple Conditions Delivers Savings Of $88 Per Episode And High Patient Approval. (February 2013.) Note: this article is about services rendered by Virtuwell, a HealthPartners online care service in Minnesota. 15 Online Care for Employers: Cost Savings Analysis (Mercer). Note: this analysis was prepared for American Well and cites American Well statistics. Global Lab Profile 5

Global Lab for Innovation

Global Lab for Innovation Global Lab for Innovation Innovation Profile Tele-Dermatology Tele-medicine technologies are used by a Primary Care Physician (PCP) to send case descriptors and photographs to a dermatologist with requests

More information

Global Lab for Innovation

Global Lab for Innovation Global Lab for Innovation Innovation Profile econsults The large-scale implementation of secure electronic communications allows primary care practitioners (PCPs) to initiate and receive electronic consultations

More information

Connected Care Delivers: Telemedicine s Value Proposition. June 8, 2015 National Council of Behavioral Health

Connected Care Delivers: Telemedicine s Value Proposition. June 8, 2015 National Council of Behavioral Health Connected Care Delivers: Telemedicine s Value Proposition June 8, 2015 National Council of Behavioral Health Agenda Introduction U.S. Market Landscape and Outlook Evidence of Cost Savings & Quality Care

More information

Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services

Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services Dale H. Yamamoto December 2014 Red Quill Consulting, Inc. 135 Park Ave, Suite 207 Barrington, IL 60010

More information

State of Payor Network and Reimbursement for Telehealth Services. Tim Maloney, UC Health Vice President of Payor Relations

State of Payor Network and Reimbursement for Telehealth Services. Tim Maloney, UC Health Vice President of Payor Relations State of Payor Network and Reimbursement for Telehealth Services Tim Maloney, UC Health Vice President of Payor Relations Introduction Reimbursement for services delivered via telehealth varies greatly

More information

Telemedicine MD consultations: satisfaction rates and use patterns among working-age adults

Telemedicine MD consultations: satisfaction rates and use patterns among working-age adults Telemedicine MD consultations: satisfaction rates and use patterns among working-age adults Mercer was retained to analyze data collected in a patient survey by TelaDoc, a national firm offering telemedicine

More information

Global Lab for Innovation

Global Lab for Innovation Global Lab for Innovation Innovation Profile Mobile Care Delivery Systems Mobile Care Delivery Systems, also called Mobile EMRs, are telemedicine platforms used by Community Health Workers to support their

More information

Global Lab for Innovation

Global Lab for Innovation Global Lab for Innovation Innovation Profile Acute Care Clinics These free-standing emergent and urgent care clinics treat patients for acute, but non-life threatening conditions, including conditions

More information

Telemedicine Offers Growth for Hospitals, Rural Care Opportunities

Telemedicine Offers Growth for Hospitals, Rural Care Opportunities Telemedicine Offers Growth for Hospitals, Rural Care Opportunities The internet and digital technology have transformed our lives, changing the way we keep in touch with our family and friends, shop, pay

More information

Telemedicine in Physical Health and Behavioral Health

Telemedicine in Physical Health and Behavioral Health Telemedicine in Physical Health and Behavioral Health Collaborative Care Summit April 16, 2015 Shabana Khan, MD Assistant Professor of Psychiatry Western Psychiatric Institute and Clinic University of

More information

TAPPING THE POTENTIAL OF TELEHEALTH. Balaji Satyavarapu [Professional IT Consulting

TAPPING THE POTENTIAL OF TELEHEALTH. Balaji Satyavarapu [Professional IT Consulting ] Balaji Satyavarapu [Professional IT Consulting TELEHEALTH What is it? As recently defined by the Telehealth Advancement Act of 2011 in Section 2290.5 of the California Business and Professions Code,

More information

Licensed Healthcare Providers Guidelines for Telemedicine Using the MyDocNow Platform

Licensed Healthcare Providers Guidelines for Telemedicine Using the MyDocNow Platform Contents 1. Scope of These Guidelines... 2 2. What is Telemedicine?... 2 3. Introduction... 3 4. What Are the Benefits of Telemedicine?... 3 5. Frequently Asked Questions Physician Care and Treatment...

More information

Remote Access Technologies/Telehealth Services Medicare Effective January 1, 2016

Remote Access Technologies/Telehealth Services Medicare Effective January 1, 2016 Remote Access Technologies/Telehealth Services Medicare Effective January 1, 2016 Prior Authorization Requirement Yes No Not Applicable * Not covered by Medicare but is covered by HealthPartners Freedom

More information

Kaiser Permanente Southern California Depression Care Program

Kaiser Permanente Southern California Depression Care Program Kaiser Permanente Southern California Depression Care Program Abstract In 2001, Kaiser Permanente of Southern California (KPSC) adopted the IMPACT model of collaborative care for depression, developed

More information

A First Look at Attitudes Surrounding Telehealth:

A First Look at Attitudes Surrounding Telehealth: A First Look at Attitudes Surrounding Telehealth: Findings from a national survey taking a first look at attitudes, usage, and beliefs of family physicians in the U.S. towards telehealth. OVERVIEW Telehealth

More information

Media Packet 10-2009. NPAM@npedu.com 888-405-NPAM. PO Box 540 Ellicott City, MD 21041

Media Packet 10-2009. NPAM@npedu.com 888-405-NPAM. PO Box 540 Ellicott City, MD 21041 Media Packet What is a Nurse Practitioner NP Facts Who are the Nurse Practitioners in Maryland State of the State Quality of NP Practice NP Cost Effectiveness 10-2009 NPAM@npedu.com 888-405-NPAM PO Box

More information

Increasing Clinician Efficiency and Patient Engagement Through Virtual Care

Increasing Clinician Efficiency and Patient Engagement Through Virtual Care Increasing Clinician Efficiency and Patient Engagement Through Virtual Care Ronald F. Dixon MD, MA Assistant Professor of Medicine, Harvard Medical School Director, Virtual Practice Project, Massachusetts

More information

Telehealth Benefits. Member FAQs

Telehealth Benefits. Member FAQs Why do people see doctors online? Telehealth Benefits Member FAQs Telehealth allows for reliable and convenient doctor visits at any time with trained and certified physicians. Patients see a doctor online

More information

Telehealth services and the Medicare program. Zach Gaumer, Amy Phillips, Ariel Winter, and Jeff Stensland November 5, 2015

Telehealth services and the Medicare program. Zach Gaumer, Amy Phillips, Ariel Winter, and Jeff Stensland November 5, 2015 Telehealth services and the Medicare program Zach Gaumer, Amy Phillips, Ariel Winter, and Jeff Stensland November 5, 2015 Presentation outline Definition of telehealth services Telehealth services under

More information

Developing a Telemedicine Business Strategy

Developing a Telemedicine Business Strategy Developing a Telemedicine Business Strategy Amber Humphrey, MBA Assistant Director, Vanderbilt Telemedicine Healthcare Financial Management Association March 22, 2016 Discussion Roadmap Defining Telehealth

More information

Unlimited No Copay Model Health care made simple.

Unlimited No Copay Model Health care made simple. Unlimited No Copay Model Health care made simple. Timely access + Lower costs + Quality care Teladoc was founded in 2002 with the vision of tackling the three biggest issues in health care. Health care

More information

Transformers: The Changing Face of Health Care Delivery

Transformers: The Changing Face of Health Care Delivery 1 Transformers: The Changing Face of Health Care Delivery Steve Lokensgard Derek Kang HCCA Compliance Institute April 21, 2015 2 Agenda People Physician Assistants Nurse Practitioners Pharmacists Radiology

More information

Telemedicine: Opportunities and Challenges

Telemedicine: Opportunities and Challenges Telemedicine: Opportunities and Challenges An Everbridge White Paper Introduction Physicians face an increasing array of non-clinical demands on their time in some practices doctors spend as much time

More information

Policy Limitations This policy applies to all places of service in accordance with the National POS code set.

Policy Limitations This policy applies to all places of service in accordance with the National POS code set. Original Effective Date: January 1, 2013 Revision Date: February 1, 2014 PROFESSIONAL EVALUATION AND MANAGEMENT SERVICES Policy NHP reimburses participating providers for the provision of medically necessary

More information

Avenues for Expanding Telehealth for Mental Health Services

Avenues for Expanding Telehealth for Mental Health Services Avenues for Expanding Telehealth for Mental Health Services September 17, 2013 During 2012, Dr. Karen Rheuban, President of the Virginia Telehealth Network, addressed the Healthy Living/Health Services

More information

Compare the Educational Requirements of Family Physicians and Advanced Practice Registered Nurses

Compare the Educational Requirements of Family Physicians and Advanced Practice Registered Nurses Per your request, LBB has reviewed material distributed by the Texas Academy of Family Physicians relating to the scope of practice of advanced practice registered nurses. This memo responds to specific

More information

Health Net Blue & Gold HMO

Health Net Blue & Gold HMO University of California Health Net Blue & Gold HMO We ve got you covered! Created for UC employees and non-medicare retirees October 2016 Health Net Blue & Gold HMO Smart. Affordable. Health care made

More information

Disclosure of Conflict of Interest

Disclosure of Conflict of Interest Challenging the Status Quo of Telehealth in Policy, Technology, & Clinical Care H. Stephen Lieber President and Chief Executive Officer HIMSS Disclosure of Conflict of Interest No Conflict of Interest

More information

Policy Limitations This policy applies to all places of service in accordance with the National POS code set.

Policy Limitations This policy applies to all places of service in accordance with the National POS code set. Original Effective Date: January 1, 2013 Revision Date: August 1, 2013 PROFESSIONAL EVALUATION AND MANAGEMENT SERVICES Policy NHP reimburses participating providers for the provision of medically necessary

More information

Your Telehealth Program:

Your Telehealth Program: 3rd Annual Telehealth Summit of South Carolina Your Telehealth Program: Are You Compliant with the Legal and Regulatory Hurdles? What Do You Need to Know to Make Sure You Don t Trip? Greg Billings Executive

More information

Telemedicine Frequently Asked Questions (FAQs) For Highmark Delaware Members

Telemedicine Frequently Asked Questions (FAQs) For Highmark Delaware Members Table of Contents Telemedicine Frequently Asked Questions (FAQs) For Highmark Delaware Members Overview and Eligibility.....Pages 1-3 Member Out-of-Pocket Costs......Pages 3-4 Amwell and Doctor on Demand

More information

The integration of telehealth How legislation and licensing boards are dealing with the new technology

The integration of telehealth How legislation and licensing boards are dealing with the new technology The integration of telehealth How legislation and licensing boards are dealing with the new technology This article is based on a presentation given by Mike Billings, PT, MS, CEEAA and Mei Wa Kwong, JD

More information

Telemedicine Reimbursement and Compliance Issues. Agenda. Telemedicine Overview Regulatory Structures. Reimbursement Operational and compliance issues

Telemedicine Reimbursement and Compliance Issues. Agenda. Telemedicine Overview Regulatory Structures. Reimbursement Operational and compliance issues Telemedicine Reimbursement and Compliance Issues Julian Rivera 512.479.9753 julian.rivera@huschblackwell.com Alison Hollender 214.999.6193 alison.hollender@huschblackwell.com Agenda Telemedicine Overview

More information

ONSITE CLINICS BRING HEALTH CARE VALUE TO THE WORKPLACE

ONSITE CLINICS BRING HEALTH CARE VALUE TO THE WORKPLACE EXECUTIVE SUMMARY ONSITE CLINICS BRING HEALTH CARE VALUE TO THE WORKPLACE Companies participating in the first Onsite Clinic User Group meeting sponsored by The Alliance are strong believers in the value

More information

PLDW. Telemedicine and the Health Care Industry PANNONE LOPES DEVEREAUX & WESTLLC. by GARY R. PANNONE Managing Partner. and

PLDW. Telemedicine and the Health Care Industry PANNONE LOPES DEVEREAUX & WESTLLC. by GARY R. PANNONE Managing Partner. and Telemedicine the Health Care Industry by GARY R. Managing Partner jillian n. jagling Associate PLDW LOPES DEVEREAUX & LOPES DEVEREAUX & WEST LLC WESTLLC counselors at law Introduction Opportunities Challenges

More information

Emerging g Trends in Home Care

Emerging g Trends in Home Care Emerging g Trends in Home Care Dana Sheer, ACNP, MSN Susan Beausoliel, BSN, MS, DNP 1 The Triple Aim Goals Quality Improve Patient Outcomes Goal Readmissions Cost Reduce costs/penalties associated w/ readmissions

More information

Keys to Health Center Success June Conference. Stewart Levy President - Health Promotion Solutions

Keys to Health Center Success June Conference. Stewart Levy President - Health Promotion Solutions 1 Keys to Health Center Success June Conference Stewart Levy President - Health Promotion Solutions 2 Agenda Introduction Definitions - Telehealth, Telemedicine, Telepresence Benefits to Healthcare System

More information

DELAWARE DISTRICT OF COLUMBIA MARYLAND. State- Specific Information Recent news, pending action:

DELAWARE DISTRICT OF COLUMBIA MARYLAND. State- Specific Information Recent news, pending action: State DELAWARE DISTRICT OF COLUMBIA MARYLAND State- Specific Information Recent news, June 27, 2012 - Delaware Medicaid program to reimburse for telemedicine- delivered services beginning July 1. Delaware

More information

REPORT 7 OF THE COUNCIL ON MEDICAL SERVICE (A-14) Coverage of and Payment for Telemedicine (Reference Committee A) EXECUTIVE SUMMARY

REPORT 7 OF THE COUNCIL ON MEDICAL SERVICE (A-14) Coverage of and Payment for Telemedicine (Reference Committee A) EXECUTIVE SUMMARY REPORT OF THE COUNCIL ON MEDICAL SERVICE (A-) Coverage of and Payment for Telemedicine (Reference Committee A) EXECUTIVE SUMMARY Telemedicine, a key innovation in support of health care delivery reform,

More information

CMS-1461-P Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

CMS-1461-P Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations February 6, 2015 Ms. Marilyn Tavenner Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, Maryland 21244 RE: CMS-1461-P Medicare

More information

Urgent Care. A Brief Overview of Urgent Care and Opportunities in an Era of Health Care Reform. Presented at NCSL, August 2014 A SNAPSHOT

Urgent Care. A Brief Overview of Urgent Care and Opportunities in an Era of Health Care Reform. Presented at NCSL, August 2014 A SNAPSHOT Urgent Care A Brief Overview of Urgent Care and Opportunities in an Era of Health Care Reform Presented at NCSL, August 2014 A SNAPSHOT 1 What Is Urgent Care? Health care provided on a walk in, no appointment

More information

HealthPartners: Triple Aim Approach to ACO Development

HealthPartners: Triple Aim Approach to ACO Development HealthPartners: Triple Aim Approach to ACO Development Brian Rank, MD Medical Director, HealthPartners Medical Group October 27, 2010 HealthPartners Integrated Care and Financing System 10,300 employees

More information

Session 14. Act Now-Review of the 2015 Telemedicine Law. 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM

Session 14. Act Now-Review of the 2015 Telemedicine Law. 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM Session 14 Act Now-Review of the 2015 Telemedicine Law 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM 1 Speakers Moderator: Mark Sonneborn Presenter: Maureen Ideker RN, BSN, MBA, Great Plains Telehealth

More information

Palliative Care Billing, Coding and Reimbursement

Palliative Care Billing, Coding and Reimbursement Palliative Care Billing, Coding and Reimbursement Anne Monroe, MHA Physician Practice Manager Hospice of the Bluegrass and Palliative Care Center of the Bluegrass Kentucky 1 Objectives Review coding and

More information

Telemedicine and Telehealth in Context. Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center

Telemedicine and Telehealth in Context. Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center Telemedicine and Telehealth in Context Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center 1 Definitions and Concepts Telehealth and Telemedicine Sometimes used interchangeably

More information

STATE OF NEBRASKA STATUTES RELATING TO NEBRASKA TELEHEALTH ACT

STATE OF NEBRASKA STATUTES RELATING TO NEBRASKA TELEHEALTH ACT 2014 STATE OF NEBRASKA STATUTES RELATING TO NEBRASKA TELEHEALTH ACT Department of Health and Human Services Division of Public Health Licensure Unit 301 Centennial Mall South, Third Floor PO Box 94986

More information

TELEMEDICINE POLICY. Page

TELEMEDICINE POLICY. Page TELEMEDICINE POLICY REIMBURSEMENT POLICY Policy Number: ADMINISTRATIVE 4.8 T0 Effective Date: May, 203 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS.. APPLICATION... OVERVIEW... REIMBURSEMENT

More information

TELEMEDICINE POLICY. Page

TELEMEDICINE POLICY. Page TELEMEDICINE POLICY REIMBURSEMENT POLICY Policy Number: ADMINISTRATIVE 4.23 T0 Effective Date: July, 205 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS.. APPLICATION... OVERVIEW... REIMBURSEMENT

More information

Onsite Health Clinics THE PAST, THE PRESENT AND THE FUTURE

Onsite Health Clinics THE PAST, THE PRESENT AND THE FUTURE Onsite Health Clinics THE PAST, THE PRESENT AND THE FUTURE Session Objectives Understand the healthcare landscape Identify the trends in onsite healthcare Highlight the benefits an onsite clinic with employer

More information

Categorizing Patient-Provider Secure Email Communications to Measure Substitutionary Effect on In-person Services

Categorizing Patient-Provider Secure Email Communications to Measure Substitutionary Effect on In-person Services Categorizing Patient-Provider Secure Email Communications to Measure Substitutionary Effect on In-person Services Ted E. Palen, PhD, MD, MSPH Institute for Health Research Colorado Permanente Medical Group

More information

The Value of OTC Medicine to the United States. January 2012

The Value of OTC Medicine to the United States. January 2012 The Value of OTC Medicine to the United States January 2012 Table of Contents 3 Executive Summary 5 Study Methodology 7 Study Findings 10 Sources 2 Executive Summary For millions of Americans, over-the-counter

More information

POLICIES AND PROCEDURES

POLICIES AND PROCEDURES POLICIES AND PROCEDURES Policy Number: QM 07 Originator: Quality and Utilization Management Department Original Issue Date: 2/99 Subject: Provider Appointment Access / Access Standards Revision Date: 11/01,

More information

Chronic Care Management (CCM) from a Physician Practice Administrator s Perspective

Chronic Care Management (CCM) from a Physician Practice Administrator s Perspective Chronic Care Management (CCM) from a Physician Practice Administrator s Perspective Chronic Care Management (CCM) from a Physician Practice Administrator s Perspective 1 ABOUT THE AUTHOR Dennis Breslin

More information

Telehealth: Today & Tomorrow National Health Policy Forum

Telehealth: Today & Tomorrow National Health Policy Forum Telehealth: Today & Tomorrow National Health Policy Forum April 11, 2014 Karen E. Edison, MD Philip Anderson Prof. & Chair, Dept. of Dermatology Medical Director, Missouri Telehealth Network Director,

More information

May 9, 2014. Hon. Mike Thompson 231 Cannon House Office Building Washington, D.C. 20515. RE: Telehealth Promotion Act of 2014. Dear Rep.

May 9, 2014. Hon. Mike Thompson 231 Cannon House Office Building Washington, D.C. 20515. RE: Telehealth Promotion Act of 2014. Dear Rep. Hon. Mike Thompson 231 Cannon House Office Building Washington, D.C. 20515 RE: Telehealth Promotion Act of 2014 Dear Rep. Thompson: On behalf of the 110,600 physician and student members of the American

More information

Provider Delivered Care Management: Frequently Asked Questions

Provider Delivered Care Management: Frequently Asked Questions Provider Delivered Care Management: Frequently Asked Questions Table of Contents Table of Contents The Basics... 2 Patient Lists... 3 Training... 3 Billing and Coding... 4 Oncology... 9 Medicare Advantage...

More information

Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF TELEMEDICINE MEDICAL SERVICE PROVIDERS UNDER MEDICAID. (a) The commission by rule shall develop and

Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF TELEMEDICINE MEDICAL SERVICE PROVIDERS UNDER MEDICAID. (a) The commission by rule shall develop and Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF TELEMEDICINE MEDICAL SERVICE PROVIDERS UNDER MEDICAID. (a) The commission by rule shall develop and implement a system to reimburse providers of services

More information

MEDICAL POLICY: Telehealth Services

MEDICAL POLICY: Telehealth Services POLICY........ PG-0142 EFFECTIVE......01/01/08 LAST REVIEW... 01/12/16 MEDICAL POLICY: Telehealth Services GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated

More information

1million Americans using. What is Telemedicine? Today there are... For the Future...

1million Americans using. What is Telemedicine? Today there are... For the Future... N A I C I T S I Y LKine H P OOlemedic T for Te 2 As telemedicine has become more widely accepted as an efficient and high-quality means to deliver healthcare by providers, payers and patients, maybe you,

More information

Amerinet Executive Education Series: Collective Learning on Contemporary Healthcare Issues. Frontiers in TeleHealth. www.amerinet- gpo.

Amerinet Executive Education Series: Collective Learning on Contemporary Healthcare Issues. Frontiers in TeleHealth. www.amerinet- gpo. Amerinet Executive Education Series: Collective Learning on Contemporary Healthcare Issues Frontiers in TeleHealth www.amerinet- gpo.com Dartmouth Atlas Report Summary: Hospital and Physician Capacity.

More information

University of Arizona Integrative Health Center

University of Arizona Integrative Health Center University of Arizona Integrative Health Center Frequently Asked Questions created for Maricopa County Employees 1. What is the Integrative Health Center? The University of Arizona Integrative Health Center

More information

Feel Better...Faster. 2014 AmeriDoc, LLC 14785 Preston e 975 Dallas, TX 75254 1-866-747-6899 www.ameridoc.com

Feel Better...Faster. 2014 AmeriDoc, LLC 14785 Preston e 975 Dallas, TX 75254 1-866-747-6899 www.ameridoc.com Feel Better...Faster 2014 AmeriDoc, LLC 14785 Preston e 975 Dallas, TX 75254 1-866-747-6899 www.ameridoc.com We Are WWW.AMERIDOC.COM PAGE 2 AmeriDoc is a leading provider of 24/7/365 on-demand healthcare

More information

Telehealth/Telemedicine:

Telehealth/Telemedicine: Telehealth/Telemedicine: The Promise and the Perils Under U.S. Law Janice F. Mulligan,Esq. Law Offices of Mulligan & Banham mulligan@janmulligan.com 619.238.8700 UIA Biotechnology Section Annual Meeting

More information

Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute

Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute Session 16: C.1. Performance Reports National Reports Some reports present information on a category of providers

More information

TELEMEDICINE, TELEHEALTH, AND HOME TELEMONITORING TEXAS MEDICAID SERVICES. Biennial Report to the Texas Legislature

TELEMEDICINE, TELEHEALTH, AND HOME TELEMONITORING TEXAS MEDICAID SERVICES. Biennial Report to the Texas Legislature TELEMEDICINE, TELEHEALTH, AND HOME TELEMONITORING TEXAS MEDICAID SERVICES Biennial Report to the Texas Legislature As Required by Texas Government Code 531.0216 Texas Health and Human Services Commission

More information

9. Additional Information

9. Additional Information 9. Additional Information 9.1 Subcontractors and Participating Practitioners KP defines a subcontractor as an individual participating practitioner, participating practitioner group, or any other entity

More information

Objectives. Family Stress. Pediatric Diabetes Complications. Diabetes Self-Management Education (DSME)

Objectives. Family Stress. Pediatric Diabetes Complications. Diabetes Self-Management Education (DSME) Objectives Recognize the problem related to lack of access to pediatric diabetes subspecialist in Rural Maryland. Appreciate the impact of pediatric telehealth delivery of care to improve access to pediatric

More information

Telemedicine Policy. Approved By 1/27/2014

Telemedicine Policy. Approved By 1/27/2014 REIMBURSEMENT POLICY Policy Number 2015R0046F Annual Approval Date Telemedicine Policy 1/27/2014 Approved By National Reimbursement Forum United HealthCare Community & State Payment Policy Committee IMPORTANT

More information

The Collaborative Models of Mental Health Care for Older Iowans. Model Administration. Collaborative Models of Mental Health Care for Older Iowans 97

The Collaborative Models of Mental Health Care for Older Iowans. Model Administration. Collaborative Models of Mental Health Care for Older Iowans 97 6 The Collaborative Models of Mental Health Care for Older Iowans Model Administration Collaborative Models of Mental Health Care for Older Iowans 97 Collaborative Models of Mental Health Care for Older

More information

Virtual Mentor American Medical Association Journal of Ethics November 2006, Volume 8, Number 11: 771-775.

Virtual Mentor American Medical Association Journal of Ethics November 2006, Volume 8, Number 11: 771-775. Virtual Mentor American Medical Association Journal of Ethics November 2006, Volume 8, Number 11: 771-775. Medicine and society Crowded conditions: coming to an ER near you by Jessamy Taylor Most people

More information

CONNECTICUT MAINE. State- Specific Information Recent news, pending action:

CONNECTICUT MAINE. State- Specific Information Recent news, pending action: State CONNECTICUT MAINE State- Specific Information Connecticut currently has no wide- scale programs involving telemedicine services, and Medicaid does not cover or reimburse for telemedicine. Pending

More information

Virginia Telemedicine Law: 17th Annual Virginia Health Law Legislative Update

Virginia Telemedicine Law: 17th Annual Virginia Health Law Legislative Update Virginia Telemedicine Law: 17th Annual Virginia Health Law Legislative Update Joseph P. McMenamin, MD, JD McMenamin Law Offices 804.921.4856 6/3/15 1 Disclaimer The views expressed here are my own, and

More information

5/6/2014. Physiologic Monitoring Tools & Use with Patients with Chronic Health Conditions. Objectives. The Issue at Hand

5/6/2014. Physiologic Monitoring Tools & Use with Patients with Chronic Health Conditions. Objectives. The Issue at Hand Physiologic Monitoring Tools & Use with Patients with Chronic Health Conditions Kelly Brittain, PhD, RN Assistant Professor MCRH-Nursing Grand Rounds May 8, 2014 Objectives 1. Summarize previous research

More information

HEALTH CARE DESIGNED AROUND You.

HEALTH CARE DESIGNED AROUND You. HEALTH CARE DESIGNED AROUND You. Health care designed around you means... Access to the best care {where you live and work. What does health care designed around you really mean? In a time when health

More information

TELEMEDICINE UPDATE:WHAT S NEW IN 2014? Vanessa A. Reynolds, P.A. vreynolds@broadandcassel.com

TELEMEDICINE UPDATE:WHAT S NEW IN 2014? Vanessa A. Reynolds, P.A. vreynolds@broadandcassel.com TELEMEDICINE UPDATE:WHAT S NEW IN 2014? Vanessa A. Reynolds, P.A. vreynolds@broadandcassel.com What is telemedicine? Telemedicine has been defined as broadly as the use of medical information exchanged

More information

Payment Policy. Evaluation and Management

Payment Policy. Evaluation and Management Purpose Payment Policy Evaluation and Management The purpose of this payment policy is to define how Health New England (HNE) reimburses for Evaluation and Management Services. Applicable Plans Definitions

More information

Memorandum. This memo provides information on the growth of retail clinics in the United States.

Memorandum. This memo provides information on the growth of retail clinics in the United States. I am a student at Columbia University. However, this comment to the Federal Trade Commission reflects my own personal opinions. This is not representative of the views of Columbia University or the Trustees

More information

New Hampshire Telemedicine Reimbursement Guide. Franconia Notch, New Hampshire

New Hampshire Telemedicine Reimbursement Guide. Franconia Notch, New Hampshire New Hampshire Telemedicine Reimbursement Guide Franconia Notch, New Hampshire The Northeast Telehealth Resource Center team is pleased to announce our 1 st edition of this Telemedicine Reimbursement Manual.

More information

11/4/2014. The Role of the Nurse Practitioner in the Gastroenterology Team. Objectives. Why?

11/4/2014. The Role of the Nurse Practitioner in the Gastroenterology Team. Objectives. Why? The Role of the Nurse Practitioner in the Gastroenterology Team Objectives Upon completion of this activity, the participant will be able to: 1 Summarize how Gastroenterology Nurse Practitioners are utilized

More information

Telehealth In Virginia. The Regulatory Landscape

Telehealth In Virginia. The Regulatory Landscape Telehealth In Virginia The Regulatory Landscape Introduction Name: Joshua Kaywood Company: WeCounsel Solutions Position: Director of Business Development Email: joshk@wecounsel.com Phone: (678) 779-4958

More information

STATEMENT. RE: Telemedicine. May 1, 2014. of the. American Medical Association. to the

STATEMENT. RE: Telemedicine. May 1, 2014. of the. American Medical Association. to the STATEMENT of the American Medical Association to the House Committee on Energy and Commerce Subcommittee on Health United States House of Representatives RE: Telemedicine May 1, 2014 Division of Legislative

More information

Telemedicine Policy Annual Approval Date

Telemedicine Policy Annual Approval Date Policy Number 2016R0046A Telemedicine Policy Annual Approval Date 4/08/2015 Approved By REIMBURSEMENT POLICY CMS-1500 Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You

More information

Telehealth Services in the United States Department of Veterans Affairs (VA) Adam Darkins Chief Consultant for Telehealth Services

Telehealth Services in the United States Department of Veterans Affairs (VA) Adam Darkins Chief Consultant for Telehealth Services Telehealth Services in the United States Department of Veterans Affairs (VA) Adam Darkins Chief Consultant for Telehealth Services VA Telehealth Services Overview VA Telehealth Is recognized as an international

More information

Telehealth Billing for Michigan RHCs and CAHs

Telehealth Billing for Michigan RHCs and CAHs Telehealth Billing for Michigan RHCs and CAHs Jonathan Neufeld, PhD Upper Midwest Telehealth Resource Center Michigan Center for Rural Health Webinar June 10, 2015 This project is/was supported by the

More information

Department of Veterans Affairs VHA DIRECTIVE 2010-010 Veterans Health Administration Washington, DC 20420 March 2, 2010

Department of Veterans Affairs VHA DIRECTIVE 2010-010 Veterans Health Administration Washington, DC 20420 March 2, 2010 Department of Veterans Affairs VHA DIRECTIVE 2010-010 Veterans Health Administration Washington, DC 20420 STANDARDS FOR EMERGENCY DEPARTMENT AND URGENT CARE CLINIC STAFFING NEEDS IN VHA FACILITIES 1. PURPOSE:

More information

4/1/2016 CURRENT STATE OF TELEHEALTH: THE VIRTUAL CLINIC WHAT IS TELEHEALTH? TELEHEALTH DOMAINS. What it is. What it is not

4/1/2016 CURRENT STATE OF TELEHEALTH: THE VIRTUAL CLINIC WHAT IS TELEHEALTH? TELEHEALTH DOMAINS. What it is. What it is not CURRENT STATE OF TELEHEALTH: THE VIRTUAL CLINIC VAN ROPER, PHD, FNP-C ASSISTANT CLINICAL PROFESSOR UNM COLLEGE OF NURSING WHAT IS TELEHEALTH? What it is The delivery of healthcare at a distance utilizing

More information

Chapter 7 Section 22.1

Chapter 7 Section 22.1 Medicine Chapter 7 Section 22.1 Issue Date: April 17, 2003 Authority: 32 CFR 199.4 and 32 CFR 199.14 1.0 DESCRIPTION 1.1 Telemedicine and Telemental Health (TMH) utilize information and telecommunications

More information

SECTION 10 1 ACCESS AND APPOINTMENT STANDARDS

SECTION 10 1 ACCESS AND APPOINTMENT STANDARDS SECTION 10 1 ACCESS AND APPOINTMENT STANDARDS Timely Access Regulations 1 Nurse Advice Line 1 After Hours Instructions 2 Appointment and Availability Standards 3 Exceptions to Appointment/Availability

More information

It is easy to point to the remarkable advances in medicine that

It is easy to point to the remarkable advances in medicine that E-Rx Collaborative, E-Prescribing: A Bridge to the 21st Century E-Prescribing has the potential to provide a bridge that will facilitate a transformation in health care delivery, which will have a remarkable

More information

What is a freestanding emergency room?

What is a freestanding emergency room? What is a freestanding emergency room? How this article can help you: This article will tell you what a freestanding emergency room is, what it treats, and how it differs from a hospital emergency room

More information

2015 U.S. Telemedicine Industry Benchmark Survey

2015 U.S. Telemedicine Industry Benchmark Survey Executive Summary - April 2015 During late 2014 and early 2015, REACH Health conducted the Industry Benchmark Survey among healthcare executives, physicians, nurses and other professionals throughout the

More information

The Computerworld Honors Program

The Computerworld Honors Program The Computerworld Honors Program Honoring those who use Information Technology to benefit society Status: Laureate Final Copy of Case Study Year: 2013 Organization Name: Miami Childrenʼs Hospital Organization

More information

REGAL MEDICAL GROUP. Important Information for Physicians Regarding Timely Access Regulations DMHC Access Standards

REGAL MEDICAL GROUP. Important Information for Physicians Regarding Timely Access Regulations DMHC Access Standards Important Information for Physicians Regarding Timely Access Regulations DMHC Access Standards DEFINITIONS: a. Advanced access means the provision, by an individual provider, or by the medical group or

More information

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service.

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service. Basic Terms How to calculate Out of Pocket Costs on a Hospital Stay: If you have a $2000 deductible and 30% coinsurance health insurance plan. If you have a $10,000 emergency room or hospital stay your

More information

Chapter 4 Health Care Management Unit 1: Care Management

Chapter 4 Health Care Management Unit 1: Care Management Chapter 4 Health Care Unit 1: Care In This Unit Topic See Page Unit 1: Care Care 2 6 Emergency 7 4.1 Care Healthcare Healthcare (HMS), Highmark Blue Shield s medical management division, is responsible

More information

Nurse Practitioner Project

Nurse Practitioner Project Nurse Practitioner Project (City Council on April 11, 12 and 13, 2000, adopted this Clause, without amendment.) The Community Services Committee recommends the adoption of the following report (March 9,

More information

Question & Answer Guide

Question & Answer Guide Joint Commission Primary Care Medical Home (PCMH) Certification for Accredited Ambulatory Health Care Organizations Question & Answer Guide A. SCORING/DECISION-RELATED Question: We are already Joint Commission

More information

A Consumer Guide to Understanding Health Plan Networks

A Consumer Guide to Understanding Health Plan Networks A Consumer Guide to Understanding Health Plan Networks Table of Contents steps you can take to understand your health plan s provider network pg 4 What a provider network is pg 8 Many people are now shopping

More information

HOUSE DOCKET, NO. 3129 FILED ON: 1/16/2015. HOUSE... No. 1944. The Commonwealth of Massachusetts PRESENTED BY: Gloria L. Fox

HOUSE DOCKET, NO. 3129 FILED ON: 1/16/2015. HOUSE... No. 1944. The Commonwealth of Massachusetts PRESENTED BY: Gloria L. Fox HOUSE DOCKET, NO. 3129 FILED ON: 1/16/2015 HOUSE............... No. 1944 The Commonwealth of Massachusetts PRESENTED BY: Gloria L. Fox To the Honorable Senate and House of Representatives of the Commonwealth

More information

OPEN MINDS 2012 Planning & Innovation Institute

OPEN MINDS 2012 Planning & Innovation Institute Panel: Trish Cavestany, MSN, RN, CCM Director, Clinical Products and Services, Robert Bosch Healthcare Systems Steve Daviss, MD Chair, Dept Psychiatry, Baltimore Washington Medical Center Chair, Committee

More information